By Karl-Klaus Dittel, Matthias Rapp
The scope and value of hip fractures is sort of incomprehensible. With an international broad occurrence of with regards to 2 million instances in line with 12 months, those fractures pose a frightening problem to our skill to impact and deal with this epidemic.
Basics for operative remedy of proximal and distal femur fractures: transparent surgical indication, brief making plans and education < 24 h, complete weight bearing osteosynthesis, early mobilisation and physiotherapy.
In complete shape the e-book offers using a in the meantime good put in implant (DMS) for osteosynthesis process within the peritrochanteric area. The ''double dynamic'' stabilization (sliding tongue precept and perspective tailored contoured healthy) ability a cutting-edge fracture therapy method. it's a convincing substitute to accomplish a organic osteosynthesis on the femur. The process comprises an infinitely adjustable, versatile perspective, dynamic plate with a tubular distal part.
Read Online or Download The Double Dynamic Martin Screw (DMS): Adjustable Implant System for Proximal and Distal Femur Fractures PDF
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Extra info for The Double Dynamic Martin Screw (DMS): Adjustable Implant System for Proximal and Distal Femur Fractures
3 shows the groups of trabeculae in the hip joint region. Three groups can be identified in the proximal femoral portion. The trabeculae that are primarily under tensile stress curve medially below the greater trochanter to the fem- Fig. 1. MRT: T-1 weighted pelvic survey (a) and magnified view of the normal right hip joint, T-1 weighted (b). a oral head, sparing the fovea capitis. The medial, main trabeculae are under stress from pressure, and form a second, triangular group which extends from the cortex at the level of the lesser trochanter to the femoral head.
They represent a continuation of the acetabular trabeculae. The secondary, lateral stress trabeculae stretch peritrochanterically from the calcar femorale and the lesser trochanter to the greater trochanter, by-passing Ward’s triangle . The widely used classification of fracture of the medial femoral neck by Pauwels is based on the angle between the fracture line and the horizontal, and differentiates between Pauwels I, II and III fractures (Fig. 4). 5 shows a fracture of the medial femoral neck of the Pauwels I type pre- and post-operatively.
The antetorsion Kirschner wire is removed as soon as the guiding wire reaches its correct position. 6 Operative procedure Fig. 13. Where the bone is hard, the lag screw is inserted up to the first mark on the screwdriver. In osteoporotic bone it is inserted up to the last mark. ] Fig. 16. After the plate is in the correct position relative to the femoral axis, it is fixed in place with the worm gear, either in valgisation or varisation. ] Drilling of the head-neck fragment Fig. 14. Once the lag screw has been positioned correctly, the handle with the safety inserter and the 11 mm centering sleeve can be removed.